One day soon, you may be waiting in line for a coffee, eyeing a pastry, when your smart watch buzzes with a warning.

Flashing on the tiny screen of your Apple Watch is a message from an app called Lark, suggesting that you lay off the carbs for today. Speak into the Apple Watch's built-in mic about your food,sleep and exercise, and the app will send helpful tips back to you.

The notion of receiving nutrition advice from artificial intelligence on your wrist may seem like science fiction. But health developers like Lark are making a bet that Apple's first wearable device, the Apple Watch, will fly off the shelves and this kind of behavior will become the norm.

Lark is just one of over a dozen health developers with new apps for the Apple Watch, which ships to consumers this week. These apps range from medication management to a button that provides instant, virtual access to a doctor.

Apple has made no secret of its health and fitness plans for the Apple Watch. And in recent months, it has recruited medical experts to work on services like ResearchKit and HealthKit, which aim to open up the flow of health data between consumers, mobile developers and medical researchers.

But is Apple doing enough to protect the privacy of your sensitive health data?

In advance of the Apple Watch's release, the company has taken some steps to put you in control of how your data is shared. You can choose to share health information with third-party apps like Lark via Apple's Health app, which comes with the device. Your health data, collected via the Apple Watch or the iPhone, is stored on Apple's HealthKit.

"Apple is leaving your HealthKit data on the device and not collecting it," said Morgan Reed, executive director at The App Association, a Washington, D.C., nonprofit that works with patient advocates and app developers.

According to Reed, this prevents third-party app developers from selling your health data without your consent.

"It also means that if an employer wants access to your health care information, they would have to demand that you give it to them," he said.

But it's still early days for the Apple Watch, and it remains to be seen whether health developers will follow Apple's privacy guidelines.

"We haven't had a developer ecosystem for a product like a smart watch," said Ben Bajarin, who specializes in consumer technology for Creative Strategies, a consulting firm. "This is [uncharted] territory."

Imagine a doctor receiving a buzz on the wrist for an e-prescription request, which could be approved with a few taps. A patient could receive a similar alert when test results are available.

Developers are exploring these possibilities and more.

"We are predisposed to small changes on the skin. It was not that long ago — and is still the case in parts of the world — that mosquitoes used to kill us with a light touch," said Ron Gutman, chief executive of HealthTap, a website and mobile app for secure video calls with a doctor.

"It is so easy to turn off a notification from a website, but you can't ignore what's on your wrist," he said.

"Be prepared to take charge of your health information, and feel free to say no to sharing data with apps."

- Morgan Reed, executive director at The App Association

Managing Medications

For patients who are juggling a variety of meds — all with different dose requirements — an Apple Watch app that sends alerts to the wrist could prove useful.

WebMD, used by millions of people to check their medical symptoms, tossed around a bunch of ideas before settling on medication adherence.

"All we wanted is for the user to be reminded that it's time to take their medication, and then quickly tell us whether they plan to take it or skip it or snooze," said Ben Greenberg, who heads up WebMD's mobile products. "That interaction demands so little." The app also instructs people whether to take their medication with food, or at a certain time of day.

But the Apple Watch's appeal may be limited to certain specialties, such as family physicians and dermatologists. Surgeons routinely remove their rings and watches before procedures, to ensure their hands stay sterile.

Moreover, doctors will need to do the work to ensure that apps they use are taking adequate steps to protect patient data. Apps may say that they are meeting privacy requirements, but most aren't properly vetted. The government has long been concerned about the proliferation of mobile health apps that make false or misleading medical claims.

Opportunities And Challenges

Privacy experts and policymakers have been worried about developers that collect and sell personal health information.

The U.S. Federal Trade Commission concluded in a recent study that developers of 12 mobile health and fitness apps were sharing user information with 76 different parties, such as advertisers.

Apple has responded to some of these fears by barring developers from selling health data that it collects via Apple devices to advertisers. After some high-profile hacks to celebrities' accounts, Apple also forbade developers to store sensitive health information in iCloud.

"Apple has clear privacy rules, but consumers should still be on guard," said Reed from the App Association. "Be prepared to take charge of your health information, and feel free to say no to sharing data with apps."

drchrono, an award­-winning Electronic Health Record (EHR) which includes all of the benefits of billing, practice management and an records in one place, will be the first to offer an integrated EHR on Apple Watch on April 24. The company is a leader in health technology: they were the first to build a native electronic health records (EHR) application for the iPad, offer developers an open healthcare API, a first-and-only EHR integration with Square and data sync with Box.

The drchrono Apple Watch app will revolutionize the physician office experience by providing automated, real-time communication between healthcare providers and patients. Physicians will be able to quickly view a patient’s information on their wrist, respond to patient messages via quick text and view a patient’s prescription refill request, all without having to access the EHR on their phone, iPad or web. As such, the app will be a seamless extension of the drchrono ipad, ipad, web and cloud experience.

“The drchrono Apple Watch app was designed with doctors’ busy lives in mind and is intended to make medical professionals more productive, efficient and organized,” says Michael Nusimow, co-founder and CEO of drchrono. “Doctors are incredibly busy; drchrono on Apple Watch gives them insights about their practice and patients just by checking their wrist. Its simply amazing to have a hands free way to gather quick insights about a patient.”

Each Apple Watch “mode” will be utilized to optimize for a physician seeing patients or on-rounds. For instance, “Glance”, which is the watch’s quick view mode will offer doctors a snapshot of their schedule. “Short Look Notifications” or short reminders, will be used to display chats or messages generated from the EHR app; a common use case could be chat messages from colleagues reminding doctors to wrap things up in advance of their next appointment. Finally, the “Long Look Notifications” mode, will offer a doctor a view of the app itself.

The drchrono Apple Watch app will be available from the Apple Watch App Store on April 24.

The "always on" smartphone world of today matched with personal digital diagnostic technologies in development by the likes of Microsoft, Apple, Google, and other digital powerhouses promise to revolutionize chronic disease management and empower population health to stratospheric levels.

The development initiatives using data created and transmitted via smartphones using wearable, clothing embedded, ingestible, and other personal sensors are limited more by imagination than technology.

Just one little problem: The ability to convert another tsunami of new patient data into usable and actionable information for physicians using existing EHR technology is more than a decade in the rearview. The existing system platforms are static warehouses, not digital highways.

Further, each EHR's warehouse is an island unto itself because it uses a different layout, nomenclature, and even language designed to make changing to a competitor as difficult as possible by making data migration to a new system an expensive and daunting process. Until Congress stepped in, exorbitant ransoms imposed by some EHR companies to translate the data into the standard language are effectively bad memories.

The Wall of Interoperability

Still, federal law, which prescribes that all EHR data is to be contained in a standard format called a CCDA (Consolidated Clinical Document Architecture, if you must know), to be certified. The law, however, has more loopholes than grandma's knitting.

That makes the new healthcare information highways, population health, and similar programs that convert EHR warehoused data into usable information for physicians and other healthcare providers (among a host of other enabling and time-saving features), the ultimate solution hobbled by that EHR industry manufactured wall to data called "interoperability."

Circumventing EHR companies by automating removal of the CCDAs out of EHR systems has been solved by a very clever few, as has even making them interactive, but it comes at a cost because each version of each EHR has to be done separately.

To achieve a single-keystroke model (inputting data only one time), which is not only desirable but the only way to get people to use it, tons of EHR data has to be machine translated into a common language, delimited, mapped, parsed, validated, and, finally, populated into a common platform so that it can be made into something useful for providers. Every day. That takes lots of time, money, and skill, which can be undone by EHR companies at will every time they issue an upgrade, new version, or even a simple update — and expensively redone.

In return, providers get useful, time-saving tools that can allow them to do much more in much less time, which is the key to a reasonable quality of life for physicians.

That makes effective population health, let alone enhancing it by new wireless, personal smartphone app-enabled diagnostics, equivalent to baking a cake by having to get and process the raw ingredients from farmers and dairies instead of a cake mix from the supermarket.

The obvious solution, of course, is to pull the data directly into the information manufacturers' systems, circumventing the EHR warehouses, which will be hoisted by their own petard in the open ocean without a paddle because information systems cannot be EHR-specific to be effective.

In the end, there is a bright future for developers, physicians, healthcare providers and, especially, patients.

EHR companies? They took a different road. The survivors will join the program, and the time to do so is so very close.

Apple Inc's (AAPL.O) healthcare technology is spreading quickly among major U.S. hospitals, showing early promise as a way for doctors to monitor patients remotely and lower costs.

Fourteen of 23 top hospitals contacted by Reuters said they have rolled out a pilot program of Apple's HealthKit service - which acts as a repository for patient-generated health information like blood pressure, weight or heart rate - or are in talks to do so.

The pilots aim to help physicians monitor patients with such chronic conditions as diabetes and hypertension. Apple rivals Google Inc (GOOGL.O) and Samsung Electronics (005930.KS), which have released similar services, are only just starting to reach out to hospitals and other medical partners.

Such systems hold the promise of allowing doctors to watch for early signs of trouble and intervene before a medical problem becomes acute. That could help hospitals avoid repeat admissions, for which they are penalized under new U.S. government guidelines, all at a relatively low cost.

The U.S. healthcare market is $3 trillion, and researcher IDC Health Insights predicts that 70 percent of healthcare organizations worldwide will invest by 2018 in technology including apps, wearables, remote monitoring and virtual care.

Those trying out Apple's service included at least eight of the 17 hospitals on one list ranking the best hospitals, the U.S. News & World Report's Honor Roll. Google and Samsung had started discussions with just a few of these hospitals.

Apple's HealthKit works by gathering data from sources such as glucose measurement tools, food and exercise-tracking apps and Wi-fi connected scales. The company's Apple Watch, due for release in April, promises to add to the range of possible data, which with patients' consent can be sent to an electronic medical record for doctors to view.

"TIMING RIGHT"

Ochsner Medical Center in New Orleans has been working with Apple and Epic Systems, Ochsner's medical records vendor, to roll out a pilot program for high-risk patients. The team is already tracking several hundred patients who are struggling to control their blood pressure. The devices measure blood pressure and other statistics and send it to Apple phones and tablets.

"If we had more data, like daily weights, we could give the patient a call before they need to be hospitalized," said Chief Clinical Transformation Officer Dr. Richard Milani.

Sumit Rana, chief technology officer at Epic Systems, said the timing was right for mobile health tech to take off.

"We didn't have smartphones ten years ago; or an explosion of new sensors and devices," Rana said.

Apple has said that over 600 developers are integrating HealthKit into their health and fitness apps.

Many of the hospitals told Reuters they were eager to try pilots of the Google Fit service, since Google's Android software powers most smartphones. Google said it has several developer partners on board for Fit, which connects to apps and devices, but did not comment on its outreach to hospitals.

Samsung said it is working with Boston’s Massachusetts General Hospital to develop mobile health technology. The firm also has a relationship with the University of California's San Francisco Medical Center.

Apple's move into mobile health tech comes as the Affordable Care Act and other healthcare reform efforts aim to provide incentives for doctors to keep patients healthy. The aim is to move away from the "fee for service" model, which has tended to reward doctors for pricey procedures rather than for outcomes.

Still, hospitals must decide whether the difficulty of sorting through a deluge of patient-generated data of varying quality is worth the investment.

"This is a whole new data source that we don't understand the integrity of yet," said William Hanson, chief medical information officer at the University of Pennsylvania Health System.

FIRST STEPS

Apple has recruited informal industry advisors, including Rana and John Halamka, chief information officer of Beth Israel Deaconess Medical Center and Harvard Medical School, to discuss health data privacy and for introductions to the industry.

The company said it had an "incredible team" of experts in health and fitness and was talking to medical institutions, healthcare and industry experts on ways to deliver its services.

A few hospitals are also exploring how to manage the data that is flowing in from health and fitness-concerned patients, whom many in Silicon Valley refer to as the "worried well."

Beth Israel's Halamka said that many of the 250,000 patients in his system had data from sources such as Jawbone's Up activity tracker and wirelessly connected scales.

"Can I interface to every possible device that every patient uses? No. But Apple can,” he said.

Cedars-Sinai hospital in Los Angeles is developing visual dashboards to present patient-generated data to doctors in an easy-to-digest manner.

Experts say that there will eventually be a need for common standards to ensure that data can be gathered from both Apple's system and its competitors.

"How do we get Apple to work with Samsung? I think it will be a problem eventually," said Brian Carter, a director focused on personal and population health at Cerner, an electronic medical record vendor that is integrated with HealthKit.

Apple opened up the Touch ID fingerprint reader to third-party developers when it released iOS 8, and some in the health care world are beginning to take advantage of it.

Drchrono, which makes an electronic health record optimized for use on iPads, has now used that capability to authenticate doctors into the patient record — and to keep unauthorized users out.

This may be part of a wider push by Apple to get iPhone 6s and iPads into the tech arsenals of enterprises like large medical groups and hospitals. The new iPad Air 2 and the iPad Mini 3 now come with Touch ID, as do the iPhone 5s, iPhone 6, and iPhone 6 Plus.

Where the medical record is concerned, the Touch ID button could be hugely effective in providing secure yet easy access. For care providers using drchrono, three taps will get them into the medical record. They rest their finger on Touch ID to get into the iPad, tap the drchrono EHR app, and then, when the app is open, they hit Touch ID once more to get into the EHR. They no longer have to enter a passcode.

“The amazing thing about Touch ID is that people sometimes forget password and PIN codes,” Drchrono COO and cofounder Daniel Kivatinos wrote on the company’s blog. “This changes the game even more … touch technology in health care.”

The first developer to make an EHR exclusively for the iPad is now aiming to be the first choice for physicians and patients looking to make the most of their new Apple Watches.

When the Apple Watch first becomes available from select retailers April 24, Mountain View, Calif.-based ambulatory EHR developer drchrono will be ready – just as is it was five years ago, when a newfangled contraption called the iPad first hit stores.

At HIMSS15 in Chicago this past week, Daniel Kivatinos, drchrono's co-founder and chief operating officer, demonstrated new software for the Apple Watch that had been in the works for months – since Apple first put out the software development kit for the device.

"The moment they release the SDK, we can build a simulator app, even though we don't actually have the physical hardware," said Kivatinos. "We did the same thing with the iPad: When we heard about the iPad in 2010, we downloaded the SDK prior to the actual hardware being released.

"The moment the physical hardware came out for the iPad, we released the app in the app store," he added. "Same situation here: The moment the physical hardware comes out, our app will be available."

Kivatinos says drchono plans to be among the first to offer an integrated EHR as soon as Apple Watch becomes available. He's excited about the device's potential to transform the office experience for doc early adopters, offering a new twist on real-time communication between physicians and their patients.

"We've thought about this a lot: What is our company, what do we do?" said Kivatinos. "Over the past several years we've realized we're creating wearable health records for doctors and patients."

With close to 70,000 physicians and more than 4 million patients registered on the drchrono platform, he said, both groups are poised to enjoy the benefits of this unique way of interaction.

"This is a completely new experience," he said. "For the first time, doctors are going to have information given to them with their hands free: A doctor could be administering a shot, picking up a child, moving an elderly person – looking at the information while doing whatever it is they need to do."

Likewise, said Kivatinos, patients should be drawn to experiencing their personal health records through a device on their wrists, using drchrono's app to schedule appointments, get medication reminders and manage their chronic diseases: "Apple creates a very nice experience for patients. It's not just about usability, it's about enjoyment."

The app will enable docs to view a patient information at a glance, respond to messages via quick text and see eRx refill requests – offering a wearable extension of the drchrono iPhone and iPad apps, according to drchrono.

"Doctors are incredibly busy; drchrono on Apple Watch gives them insights about their practice and patients just by checking their wrist," said CEO Michael Nusimow in a press statement. "Its simply amazing to have a hands-free way to gather quick insights about a patient."

Plenty of other vendors have already readied software for the Apple Watch's release, of course, and many of them were showcasing it at HIMSS15. Epic, Cerner, athenahealth, Vocera, Mayo Clinic and more all announced apps – or plans for apps – at the show.

Kivatinos said he's confident drchrono's early leadership among curious early adopters of Apple technology will keep them well-positioned among physician practices.

"If you look at the early days in 2010, we put our (iPad) app out the first week and had thousands and thousands of docs download it," he said. "It took some of our competitors years to get to that point."

Physicians "want innovation, but they want it to work," said Kivatinos. "We had one doctor who bought a $100,000 EHR, and came to us a week later and said, 'This doesn't work. What do you guys have?' He literally just junked it. If it doesn't work, they're just going to walk away."

The critical questions? "Is it usable, is it designed well, can I just put information into it and walk away quickly? Can I just do my rounds? I don't want this thing in my way."

The company touts different "modes" for the Apple Watch app, depending who's using it and how. "Glance" offers a quick view, giving docs a snapshot of their patient schedule for the day. "Short Look Notifications" can display brief messages generated from the EHR app. "Long Look Notifications" offer a doctor a view of the app itself.

Kivatinos says he's "100 percent" certain the Apple Watch is going to catch on in a big way among consumers – and his customers.

Kivatinos says he's convinced it's an Apple to oranges comparison. Glass, with its temple tapping and head nodding, necessitated a new and sometimes questionable type of social etiquette, he said. The "experience was a little different: harder to set things up and install," he said – to say nothing of the cost.

"I bought a Google Glass. It cost $2,000 with prescription lenses," he said. "$2,000 and $350 is a drastic difference. Price point is so critical."

Whether it's docs looking for easy access to vital signs, staff messaging, e-prescriptions and labs; or patients looking for an attractive and convenient interaction to manage their meds or schedule appointments, he's convinced the Apple Watch will find favor among folks and physicians alike.

Not settled with simply being the dominant device on which clinical data applications are hosted, Apple made another step towards becoming an even more ubiquitous presence at healthcare organizations last week when it launched ResearchKit.

ResearchKit is a platform that allows healthcare organizations to host apps that will get people to participate in clinical trials. During an event for the press, the company announced a few initial partnerships with major healthcare provider organizations to use ResearchKit, including Icahn School of Medicine at Mount Sinai, Penn Medicine, Dana-Farber Cancer Institute, Massachusetts General Hospital, Stanford Hospital, and more.

ResearchKit builds off HealthKit, which was a health platform Apple launched last year that aimed to connect personally-generated health data and clinical data. Since HealthKit’s launch, many notable healthcare organizations, including Stanford Medicine, Cleveland Clinic, and EHR vendors like Epic, have all partnered with Apple to work in their own patient-generated data applications.

The Cupertino, Calif.-based company is part of a wider movement in the industry to bring patient-generated health data (PGHD), from various portals and monitoring devices, into clinical data applications like the electronic medical record (EMR). The Office of the National Coordinator for Health IT (ONC), in its proposed rule for Stage 3 of meaningful use, made integrating PGHD into the EHR a requirement for eligible hospitals and providers.

Of course, this integration is easier said than done. Healthcare Informatics Senior Editor Gabriel Perna spoke with Rob Faix, principal advisor at the Naperville, Ill.-based consulting firm, Impact Advisors on the most recent edition of the Healthcare Informatics podcast. Faix discusses the challenges of bringing together patient and clinical data; why Apple has taken the lead in this category with many prominent healthcare organizations; and how ResearchKit can be a game changer.

“Integrating this data will be a significant challenge but I think it’s one that hardware device vendors, software developers, and EMR vendors are up for…it’s the next big opportunity,” Faix says. “

Faix talks about how this integration may happen. He predicts there will be a staging process, where PGHD is graded and reviewed. “Context will be important. The software and EMR vendors and the clinical community are really going have to think about that as we integrate PGHD into the EMR,” he says.

Sifting through a potential avalanche of data will present itself as a challenge, as will having to deal with potential issues of liability. “I have information in front of me that I chose to accept or discard, and therefore, it could be tied back to an adverse event,” Faix says.

South Jordan, Utah – February 24, 2015– ADP® AdvancedMD, a leader in all-in-one, cloud electronic health record (EHR), practice management, medical scheduling, medical billing services as well as a pioneer of big data reporting and business intelligence for smaller medical practices, today announced the release and availability of AdvancedMD ICD-10 Toolkit, a free app that gives private practices a suite of ICD-10 preparation tools. Now anyone with an iPhone or iPad running iOS8 can easily test their readiness and train staff for the October 1deadline, free of charge. Customers of AdvancedMD practice management software can also leverage the app to add ICD-10 codes to their charge slip templates.

“ADP AdvancedMD has been a leader in the ICD-10 transition process and a champion of independent physicians and small practices, with such tools as MyICD10.AdvancedMD.com, a website aimed at helping medical practices prepare for the ICD-10 transition, featuring a timeline and a wealth of tools, training and tips to help practices prepare for the change,” said Raul Villar, president, ADP AdvancedMD. “With less than half of all practices ready for the change, we saw a need for a tool that would aid the entire community of independent physicians in their progress.”

The app was created as part of the ADP AdvancedMD iCommit program, which offers incentives to engineers for independently pursuing innovations in addition to their regular jobs.

“We decided that there should be a tool to help everyone prepare for the change to ICD-10 and give our community the ability to gauge their readiness,” said Barlow Tucker, software engineer, ADP AdvancedMD. “A free app was the clear choice because it’s easy to access and use, plus it allows people to get an ICD-10 ‘checkup’ at any time.”

Apple now introduced the biometric “Touch ID” onto the new iPad, latest iPad Air 2 and the iPad Mini 3. Touch ID is also on the iPhone 5s, iPhone 6 and iPhone 6 Plus.

What is Touch ID? Touch ID is a little biometric finger print reader on the new iOS devices:

iPad Air 2

iPad Mini 3

iPhone 5S

iPhone 6

iPhone 6 Plus

With Touch ID, you can now do more with just the touch of a finger, you can log in and verify identity in logging into apps. Touch ID is that little metal ring around the home button on the new iOS devices.

With the introduction of “Touch ID” onto the new iPad we have added something amazing. With three taps you can get into a medical record. You will touch once with Touch ID to get into the iPad, tap the drchrono EHR app, once the app is launched, then with Touch ID, get into their EHR. Only three taps, no typing a passcode.

The great thing about Touch ID is that it only takes a few minutes to setup. To setup Touch ID EHR follow this video, this video applies to all iOS devices with Touch ID, in the video I am showing how you can use an iPhone 6 to setup Touch ID EHR, it is the same for the new iPad Air 2 and iPad Mini 3:

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